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Surge in Incidence and Coronavirus Disease 2019 Hospital Risk of Death, United States, September 2020 to March 2021.
Patel, Bela; Murphy, Robert E; Karanth, Siddharth; Shiffaraw, Salsawit; Peters, Richard M; Hohmann, Samuel F; Greenberg, Raymond S.
  • Patel B; Division of Pulmonary, Critical Care and Sleep Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA.
  • Murphy RE; School of Biomedical Informatics, University of Texas Health Science Center at Houston, Texas, USA.
  • Karanth S; Division of Pulmonary, Critical Care and Sleep Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA.
  • Shiffaraw S; School of Biomedical Informatics, University of Texas Health Science Center at Houston, Texas, USA.
  • Peters RM; Department of Population Health, Dell Medical School, University of Texas at Austin, Austin, Texas, USA.
  • Hohmann SF; Center for Advanced Analytics and Informatics, Vizient, Chicago, Illinois, USA.
  • Greenberg RS; Department of Population Health and Data Sciences, School of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Open Forum Infect Dis ; 9(10): ofac424, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2062947
ABSTRACT

Background:

Studies of the early months of the coronavirus disease 2019 (COVID-19) pandemic indicate that patient outcomes may be adversely affected by surges. However, the impact on in-hospital mortality during the largest surge to date, September 2020-March 2021, has not been studied. This study aimed to determine whether in-hospital mortality was impacted by the community surge of COVID-19.

Methods:

This is a retrospective cohort study of 416 962 adult COVID-19 patients admitted immediately before or during the surge at 229 US academic and 432 community hospitals in the Vizient Clinical Database. The odds ratios (ORs) of death among hospitalized patients during each phase of the surge was compared with the corresponding odds before the surge and adjusted for demographic, comorbidity, hospital characteristic, length of stay, and complication variables.

Results:

The unadjusted proportion of deaths among discharged patients was 9% in both the presurge and rising surge stages but rose to 12% during both the peak and declining surge intervals. With the presurge phase defined as the referent, the risk-adjusted ORs (aORs) for the surge periods were rising, 1.14 (1.10-1.19), peak 1.37 (1.32-1.43), and declining, 1.30 (1.25-1.35). The surge rise in-hospital mortality was present in 7 of 9 geographic divisions and greater for community hospitals than for academic centers.

Conclusions:

These data support public policies aimed at containing pandemic surges and supporting healthcare delivery during surges.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: Open Forum Infect Dis Year: 2022 Document Type: Article Affiliation country: Ofid

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: Open Forum Infect Dis Year: 2022 Document Type: Article Affiliation country: Ofid